Report points to need to address physician shortages

By Christine SextonThe News Service of Florida

Wednesday

Dec 13, 2017 at 3:35 PMDec 13, 2017 at 3:35 PM

TALLAHASSEE — Florida hospitals have seen a 29 percent increase in the number of residency slots since 2013, but the state still faces physician workforce challenges, a report on graduate medical education released Wednesday shows.

The report, “Training Tomorrow's Doctors: Graduate Medical Education in Florida 2017,” shows that Collier, Lee and Sarasota counties face a severe shortage of primary-care physicians. Moreover, despite the state adding 1,113 residency slots in the last four years, the report shows that the number of residencies in neurology, thoracic surgery, nephrology and ophthalmology has declined.

Steve Sonenreich, president and CEO of Mount Sinai Medical Center, said he hopes lawmakers will consider the findings as they meet in January to begin working on a state budget for the upcoming year. He would like the Legislature to provide Southwest Florida hospitals a $100,000 bonus for each graduate medical education primary-care residency created and to provide another $5 million to entice hospitals to retain graduate medical education slots in neurology, thoracic surgery, nephrology and ophthalmology.

“What we are trying to do is to bring to the forefront the population continues to grow and the population continues to age, and access to physicians — everybody has heard a story of friends, neighbors — the difficulty in gaining access to physicians,” he told The News Service of Florida. “Additional funding to support graduate medical education is in our institutions is something very important.”

The request is in addition to already-existing graduate medical education initiatives. In 2013, lawmakers directed $80 million in recurring funding and directed it toward the Statewide Medicaid Residency Program. The state had an estimated 3,896 residency slots before the program was created. Since then, Florida has funded an additional 1,113 slots for a total of 5,009. Lawmakers in 2017 agreed to direct an additional $17 million to the program to keep pace with the growing demand.

The 2017 report was published by the Safety Net Hospital Alliance of Florida in partnership with the Teaching Hospital Council of Florida, which Sonenreich chairs. It builds off the findings of a 2015 analysis conducted on behalf of the groups by IHS Markit, formerly IHS Global, which found Florida faced a shortage of nearly 7,000 physicians through 2025.

In response to the 2015 report, lawmakers created the Graduate Medical Education Startup Bonus and Retention Program where hospitals are paid a one-time $100,000 startup bonus for every residency slot created in a shortage specialty. This year, the program resulted in the creation of 313 new residency positions in many of the 20 physician specialties where deficits exist.

Sonenreich said his group's goal is to ensure that tax dollars are directed to support residency slots in areas that will help the state the most.

“What we're really talking about here is trying to formulate good public policy, and good public policy is to identify where our community, our state, has a deficiency and then try to encourage funding of those residencies so they are available for people to take advantage of,” he said.

In addition to requesting money to train future physicians, the Safety Net Hospital Alliance of Florida and the Teaching Hospital Council of Florida also are requesting that the Legislature appropriate $50 million to help offset the costs of charity care provided by teaching hospitals.

The Safety Net Hospital Alliance of Florida's 14 member hospitals provided nearly $580 million in charity care but received about $209 million in supplemental payments from the Low Income Pool program, according to Executive Vice President Lindy Kennedy.

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